How the rest of the world brushes their teeth

How is it that some people who have never used a toothbrush have also never had a cavity?

Muslim and African cultures clean their teeth with a stick called miswak, which naturally has a high concentration of cavity-fighting fluoride. (Photo: Zurijeta/Shutterstock)

There’s a 99 percent chance you are not super rich. But there is a good chance that you are part of the orally hygienic elite 1 percent.

While it’s common in the U.S. and other developed countries to use nylon and electronic toothbrushes, most of the world’s population, especially indigenous cultures and developing countries, still use old-world techniques to keep their teeth clean — if they use anything at all.

But are modern oral hygiene products and techniques infinitely better than the sticks, animal bristles and bones, twigs, feathers and porcupine quills that non-first-world societies used centuries ago — or continue to use today — to clean their teeth?

Is what one eats more important in determining oral hygiene than the materials used to clean the teeth and gums?

In other words, if tribes, clans and indigenous societies stick with their traditional diets and don’t eat processed sugar and junk food, is teeth-brushing even necessary?

Lack of oral hygiene can lead to heart disease, maybe
A 2010 study published in the British Medical Journal concluded that people who brushed less than twice a day had an increased risk of developing cardiovascular disease, due to inflammation and loss of connective tissue and bone support of the teeth. In the BMJ study, people who brushed their teeth less than twice a day, habitually, had a 70 percent higher risk of developing cardiovascular disease. The study, however, did not consider the participants’ diets.

But Sally Fallon, president of the Weston A. Price Foundation, a nonprofit nutrition education foundation, tells Mother Nature Network that in traditional societies that have no access to Western foods with processed sugars and white flour, many of these indigenous people have no cavities, and flash smiles with perfect pearly white teeth, even though tooth brushing is rare, (or was rare, depending on the society).

“Within a very short time of forgoing their traditional, native diets, though, cavities become evident,” says Fallon, adding that the next generation of natives who eat processed food will begin to develop crooked teeth.

Fallon points to the research pioneered by the foundation’s namesake, Dr. Weston Price, an Ohio dentist, referred to in some circles as the "Charles Darwin of nutrition." The late Price, in the 1930s, traveled the world as a sort of a cultural dental anthropologist. His book, "Nutrition and Physical Degeneration," features many photos of the teeth of various native societies, from isolated villagers in the Swiss Alps, to the Maori of New Zealand, to the coldwater fishermen of Scotland’s Hebrides islands.

Vitamin K to the rescue
Price discovered a substance he termed "Activator X" that all the natives with healthy teeth had in their saliva. Price didn’t know exactly what Activator X was, but shortly after his studies, science classified the cavity combating compound as vitamin K. A study published in the Journal of Dental Research states that in 1942, it was proven that vitamin K prevented the formation of acid buildup, which is a major cause of cavities.

Some of the foods that are high in vitamin K that Price observed traditional societies consuming were:

Chicken or goose liver

Fermented foods like sauerkraut

Grass-fed animal fat

Grass-fed, raw butter

Egg yolks

So should you run to your nearest health food store and swallow a pill of vitamin K and not worry so much about brushing your teeth twice a day? And perhaps buy some goose liver?

“There’s nothing wrong with brushing twice per day. We are genetic mongrels in America. None of us has a perfect diet, so I would definitely recommend brushing your teeth,” Fallon says.

It’s not just junk food that causes cavities
Dr. Jacquie Fulop Goodling, a Manhattan-based orthodontist who has traveled the world educating people about oral health, addresses a common misconception that modern-day processed foods alone contribute to dental caries.

“Diet plays an important role but even natural carbohydrates like bread, rice and pasta — the staple in many diets — break down into simple sugars, which can cause decay. Also, there are many factors contributing to periodontal disease and diet is only one of those factors,” Goodling says.

Some societies that don’t use toothbrushes
“In many regions of the world, people are cleaning their teeth with twigs, most often from oak and neem trees,” says Dr. Steven Goldberg, a Boca Raton, Fla., general and cosmetic dentist and inventor of a modern oral care product, DentalVibe.

“They break a twig in half, splay and soften the broken end and then rub it on their teeth, in effect, wiping the surface of their teeth clean,” Goldberg adds.

Arab Bedouin tribes still clean their teeth by using the twigs of the arak tree, which contains antiseptic properties. Other Muslim and African cultures use a similar stick, called miswak, which naturally has a high concentration of cavity-fighting fluoride.

A paper posted on the National Academy of Dentistry’s website says that Hindu Brahmins and priests clean their teeth using cherry wood for an hour, facing the rising sun. Another religious group in India, Jains, cleans their teeth using fingers and without using a brush.

In other rural areas of India, people use twigs from mango, cashew or coconut trees.

What some cultures use for toothpaste
Some folk in rural India, Africa, Southeast Asia and South America use brick, charcoal, rangoli powder, mud, salt or ash for cleaning the teeth. This may result in gingival recession, abrasion and dentin sensitivity, says the National Academy of Dentistry.

Should Americans ditch their toothbrushes and clean with sticks instead?

The inconvenient truth about going to the dentist at least twice a year and replacing your toothbrush is that all the discarded toothbrushes and toothpaste containers end up in the landfill. But it seems that Americans are in no rush to clean their teeth with twigs. Toothpaste, whiteners, sugarless gum, mouthwash, manual or electric toothbrushes, floss, and other oral care items retailed at $9.1 billion in 2008, according to the U.S. Market for Oral Care Products, 7th Edition.

Whether or not you choose to go native and clean your teeth with a tree twig, “Oral hygiene can be a very important component to our overall health. The mouth is full of bacteria and not caring for it can cause inflammation. The gums can become unhealthy if proper dental hygiene is neglected and this can create low-grade infection that can cause inflammation and other problems throughout the body,” says Rebecca Crowley-Huey, physician assistant at BodyLogicMD of Houston, who adds, “Brain fog, autoimmune disease, gut infection or imbalance, and fatigue can be some of the problems caused by inflammation and your mouth is sometimes your first line of defense against foreign material.”

Two times a day is much better than only one time per day, says Steve Krendl, a dentist at Hopewell Dental in Heath, Ohio. “A thin film of organic matter, called a biofilm, forms quickly on our teeth throughout a day. Left undisturbed, this turns into plaque, which can harden within 24 hours.”

Now that’s something to chew on.

Do you brush twice per day — and floss? Let us know below.

Judd Handler is a health writer in Encinitas, Calif. He can be reached via email at CoachJudd@gmail.com.